Minimally invasive procedures are continually increasing in number and variation in part because such techniques offer an immediate advantage over more traditional, yet highly invasive surgeries. Endoscopic surgery, for example, uses one or more scopes inserted through small incisions for diagnosing and treating disease. In particular, endovascular surgery gives access to many regions of the body, such as the heart, through major blood vessels. Typically, the technique involves introducing a surgical instrument percutaneously into a blood vessel, such as, for example, the femoral artery. The currently emerging percutaneous endovascular procedures include aortic valve replacement, mitral valve repair, abdominal and thoracic aneurysm repair and tricuspid valve replacement. Other procedures requiring access to the femoral artery include coronary, carotid and cerebral angiographic procedures.
A key feature of these minimally invasive surgical procedures is the forming of a temporary pathway, usually an incision, to the surgical site. For example, in the emerging percutaneous endovascular procedures, an access site (e.g. incision) ranging from approximately 10 to 30 French units is formed as a temporary pathway to access the surgical site. Various instruments, such as procedural sheaths, guidewires and catheters, are then inserted through the access site, as well as specialized medical instruments, such as, balloon catheters and stents.
Currently, incision or access sites are routinely closed via cut-down surgical repair. This method is very invasive and fraught with complications. Accordingly, the rapid development of percutaneous endovascular surgery, of which interventional radiology and cardiology are a major component, has led to the need for instrumentation to minimize the risk of complications associated with closing the access site after a procedure.